#4 You’re just plain turned off. It happens. Whether it’s the weight your partner has put on, the realization that you’re having period sex, or you’re just not getting what you need in the bedroom, at some point in your life, you’re going to be turned off enough to lose *or be unable to attain* your hard-on. [Read: Not attracted to your girlfriend anymore? The why and the fixes]
For more information please refer to the erectile dysfunction article. There are also other causes of problems in bed like enlarged prostate, or you may be interested in general male enhancement. This is not the subject we are talking about. The main purpose of this review is to let you know how to get an erection when you need it. We will take a look at the products and techniques that will help you get an instant erection on demand. Face it, if you want to take total control of a woman, you just can't let concerns about your performance disrupt the thrill and momentum of spontaneous, passionate sex. You want to know without a doubt that you'll be as hard and as hot and as enduring as you ever dreamed. And you want it now. Now means instant erection when you need it.
In patients with low testosterone, testosterone treatment can improve libido and erectile dysfunction, but many men still may need additional oral medications such as sildenafil, vardenafil, or tadalafil. Some studies suggest that men with ED and low testosterone may respond better to PDE5 inhibitors when given testosterone therapy; however, this is controversial.
How men can improve their sexual performance Many men want to know how to enhance their own and their partners’ sexual satisfaction. However, placing too much emphasis on performance can lead to anxiety. Certain lifestyle changes can help to reduce sexual anxiety, improve erectile dysfunction, and increase stamina. In this article, we describe 13 methods to try. Read now
You're right that this should be a last resort, but Paduch also agrees that sometimes a little confidence can help you get back on track. The thing is, you should only take an ED medicine if it's prescribed by your doctor (otherwise you'll miss out on the important medical info you should know before you take it). Another option is an l-arginine supplement, which can increase nitric oxide and blood flow.
Patients should continue testosterone therapy only if there is improvement in the symptoms of hypogonadism and should be monitored regularly. You will need periodic blood tests for testosterone levels and blood tests to monitor your blood count and PSA. Testosterone therapy has health risks, and thus doctors should closely monitor its use. Testosterone therapy can worsen sleep apnea and congestive heart failure.

Name of DrugWhen to TakeDoseDietary RestrictionsViagraTake between 30 and 60 minutes (and up to 4 hours) before sex; works for about 4 hoursRecommended dose for most men is 50mgs; after that, dosage may go to as high as 100mg, or as low as 25mg, which may be prescribed for men over 65.Quickly absorbed by the body, less effective after a high-fat meal, and best taken on an empty stomach.Name of DrugWhen to TakeDoseDietary RestrictionsLevitraTake 1 hour before sex; works for 4 to 5 hours, and may be slightly more effective than ViagraStarting dose for most men is 10mgs a day, but men over 65 often start on the 5mg pill.Can be taken with or without food, although slightly less effective after a high-fat meal.  Avoid anything containing grapefruit juice; it may make side effects worse.Name of DrugWhen to TakeDoseDietary RestrictionsCialisComes in two forms. The daily pill stays effective in between doses, but may take 4 to 5 days before it begins working. The “weekender” version of Cialis can start working in as little as 30 minutes for men who take the highest dose of the drug (20mgs); it stays effective in the body for up for 36 hours.Daily pill comes in both a 2.5mg and 5mg tablet; most men start with the lower dose. The use-as-needed, “weekender” pill comes in 5, 10 and 20mg strengths; recommended starting dose is 10mg,Can be taken with or without food.   Avoid heavy drinking (5 glasses of wine or 5 shots of whiskey); when combined with Cialis, it can lead to headaches, dizziness, an increase in heart rate, and a drop in blood pressure.Name of DrugWhen to TakeDoseDietary RestrictionsStaxyn Take 1 hour before sex, although many men report erections in 20 to 30 minutes.  Because Staxyn comes in a sleek black package and is taken as a rapidly dissolving tablet (without water), some men think of it as a more discrete way to treat ED.Comes in 10mg tablets; do not take more than 1 a day.Avoid taking it with any kind of liquid. Should be placed directly on the tongue and allowed to dissolve without chewing.Name of DrugWhen to TakeDoseDietary RestrictionsStendraPrescribing information now recommends taking it 30 minutes before sex. Some men, however, report results in as little as 10 to 12 minutes, depending on the dose. Because of these findings, Auxilium Pharmaceuticals, the Chesterbrook, Pa., company that has U.S. marketing rights to the drug, has asked the FDA to revise the prescribing information.Starting dose is 100mgs for most men, but the 50mg tablet is recommended for men taking alpha-blocker drugs, like those used for high blood pressure and prostate problems.May be taken with or without food, and with a moderate amount of alcohol (3 drinks).   Drinking more than that can increase the chances of side effects like rapid heart rate, low blood pressure, dizziness and headaches.Name of DrugWhen to TakeDoseDietary RestrictionsPenile injections & the MUSE suppositoryTake 5 to 10 minutes before planning to have sex; erections last for 30 to 60 minutes.MUSE comes in 4 dosage strengths; most men start at 125mgs. Avoid taking more than twice within a 24-hour period.N/A


Prostate cancer isn’t considered a cause of ED on its own, but radiation treatments, hormone therapy, and surgery to remove the entire prostate gland can lead to difficulty in getting or keeping an erection. Sometimes erectile dysfunction related to prostate cancer treatment is only temporary, but many guys experience ongoing difficulties that need to be addressed by other means.


Psychosexual counselling, or sex therapy, is an appropriate recommendation especially for men who are experiencing discord with their partner especially if the conflict is related to the man’s ED. Counselling usually consists of 5–20 sessions with counsellor. It is our recommendation that referral doctors treating men with ED make a referral to a psychotherapist or sex therapist who is certified by AASECT (American Association of Sexuality Educators, Counselors and Therapists) of certified sexuality educator.43
Erection is a vascular event. The penis becomes rigid when blood flow to the corpora cavernosa increases sixfold and venous outflow is physiologically impeded. Penile perfusion is governed by three organ systems—the neurologic, circulatory, and endocrinologic systems—each necessary for potency. The neurologic system accounts for vasodilation and venoconstriction of the corporal blood vessels so that blood is shunted to the erectile tissues; the circulatory system provides adequate blood flow to the hypogastric-cavernous bed, a distal branch off the internal iliac vessels; and the endocrine system, mediated by testosterone, plays a permissive role through mechanisms that have yet to be elucidated.
Endocrine evaluation consisting of a morning serum testosterone is generally indicated. Measurement of serum prolactin may be indicated. A low testosterone level merits repeat measurement together with assessment of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin levels. Other tests may be helpful in excluding unrecognized systemic disease and include a complete blood count, urinalysis, creatinine, lipid profile, fasting blood sugar, and thyroid function studies.
The inflatable type of device consists of cylinders that are implanted in the corpora cavernosa, a fluid reservoir implanted in the abdomen, and a pump placed in the scrotum. The man squeezes the pump to move fluid into the cylinders and cause them to become rigid. (He reverses the process by squeezing the pump again.) While these devices allow for intermittent erections, they have a slightly higher malfunction rate than the silicon rods.
The rumors are true. Having too much to drink can interfere with a man’s ability to have an erection. According to Everyday Health, alcohol is a depressant. This means that, along with dampening your ability to think, speak, and move efficiently, it can also dampen mood, decrease sexual desire, and make it difficult for a man to achieve erection or reach an orgasm. This is because alcohol decreases blood flow to the penis. That not only may reduce a man’s ability to have an erection, but even if he is lucky enough to get it hard, alcohol can reduce the intensity of his orgasm.

What happens is that the blood vessels of the penis are rather small, and a small amount of plaque in the penile arteries is going to result in erectile dysfunction. You need more plaque before the person’s actually symptomatic from a heart problem, but they’re linked. And so when anybody, any man has an erectile issue, it’s incumbent upon the physician to make certain that their cardiac status is healthy.
NO is produced by the enzyme NO synthase (NOS). [13] NOS plays many roles, ranging from homeostasis to immune system regulation. To date, 3 subtypes have been identified: nNOS, iNOS, and eNOS, which are produced by the genes NOS1, NOS2, and NOS3, respectively. This nomenclature is derived from the sources of the original isolates: neuronal tissue (nNOS), immunoactivated macrophage cell lines (iNOS), and vascular endothelium (eNOS). The subtypes are not, however, limited to the tissues from which they were first isolated.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is sage, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
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